This case features a 58-year-old male with a dilated aorta and sever aortic regurgitation.  The procedure began with an incision through the manubrium and upper sternum extending to the third intercostal space, followed by a T-shaped incision. The pericardium was carefully tucked under the retractor, bringing the aorta up using an Estech retractor.   

A high aortic cannulation was placed, and a stylet was inserted into the aortic canula without requiring hand placement within the ministernotomy. Retrograde cardioplegia cannula was placed and femoral venous cannulation was performed. The aorta was opened, and the dilated aorta was excised.   

The aortic valve leaflets were removed, and the horizontal mattress sutures were placed, followed by the placement of the 29 mm Mosaic valve.  After this, a Dacron graft was placed to the proximal and distal aorta.  

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